Organization
KATHLEEN MILLER, LSW, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN BRIGHID MILLER LCSW (SOLE PROPRIETOR)
(814) 505-4241
Entity
Organization
Contact information
Practice address
IDA TOWERS OFC 101012TH, ALTOONA, PA 16601-3411
(814) 505-4241
Mailing address
120 EVERGREEN LN, MARTINSBURG, PA 16662-7059
(814) 505-4241
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW127247
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102394936 0001
MA NUMBER
PA
Enumeration date
08/09/2010
Last updated
02/04/2011
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